Studies of the epidemiology of ankle fractures in patients over 65 years of age and in older women in the US suggest that they occur with a frequency of 1.5 to 5.3 per 1000 people, with the highest frequency being white women and the lowest being non-white men.[11]Koval KJ, Lurie J, Zhou W, et al. Ankle fractures in the elderly: what you get depends on where you live and who you see. J Orthop Trauma. 2005;19:635-639.
http://www.ncbi.nlm.nih.gov/pubmed/16247309?tool=bestpractice.com
[12]Hasselman CT, Vogt MT, Stone KL, et al. Foot and ankle fractures in elderly white women. Incidence and risk factors. J Bone Joint Surg Am. 2003;85:820-824.
http://www.ncbi.nlm.nih.gov/pubmed/12728031?tool=bestpractice.com
The most common fracture pattern is an isolated fibular fracture (51% to 58%) and then, in decreasing order of frequency, bimalleolar fracture (about 27%), trimalleolar fracture (about 14%), and isolated medial malleolar fracture (about 8%).[11]Koval KJ, Lurie J, Zhou W, et al. Ankle fractures in the elderly: what you get depends on where you live and who you see. J Orthop Trauma. 2005;19:635-639.
http://www.ncbi.nlm.nih.gov/pubmed/16247309?tool=bestpractice.com
[12]Hasselman CT, Vogt MT, Stone KL, et al. Foot and ankle fractures in elderly white women. Incidence and risk factors. J Bone Joint Surg Am. 2003;85:820-824.
http://www.ncbi.nlm.nih.gov/pubmed/12728031?tool=bestpractice.com
European and Canadian epidemiological data suggest that ankle fractures occur in patients with an average age of 40 to 46 years, and, in those younger than 65 years of age, the predominance is male. The most common mechanism is usually a fall (about 38% to 80%) and the most common fracture is of the lateral malleolus (70%).[4]Court-Brown C, McQueen M, Tornetta P 3rd. Ankle fractures. In: Tornetta P 3rd, Einhorn T, eds. Trauma, orthopaedic surgery essentials. Philadelphia, PA: Lippincott Williams and Wilkins; 2006.[13]Weening B, Bhandari M. Predictors of functional outcome following transsyndesmotic screw fixation of ankle fractures. 2005;19:102-108.
http://www.ncbi.nlm.nih.gov/pubmed/15677926?tool=bestpractice.com
[14]Jensen SL, Andresen BK, Mencke S. Epidemiology of ankle fractures. A prospective population-based study of 212 cases in Aalborg, Denmark. Acta Orthop Scand. 1998;69:48-50.
http://www.ncbi.nlm.nih.gov/pubmed/9524518?tool=bestpractice.com
Bimalleolar (16%), trimalleolar (7.5%), and isolated medial malleolar fractures (about 6%) follow a similar pattern to US studies.[4]Court-Brown C, McQueen M, Tornetta P 3rd. Ankle fractures. In: Tornetta P 3rd, Einhorn T, eds. Trauma, orthopaedic surgery essentials. Philadelphia, PA: Lippincott Williams and Wilkins; 2006. Open fractures occur infrequently (1.7%), as do higher-energy fractures resulting from a motor vehicle accident (about 4%).[4]Court-Brown C, McQueen M, Tornetta P 3rd. Ankle fractures. In: Tornetta P 3rd, Einhorn T, eds. Trauma, orthopaedic surgery essentials. Philadelphia, PA: Lippincott Williams and Wilkins; 2006.